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FNP Board > Diagnosis > Flashcards

Diagnosis Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

How to make a dx of Migrains w/o aura

A

2:
-unilateral
-pulsating
-mod/sever
-avoidance of activity
1:
-N/V
-photo/phonaphobia

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2
Q

how to make dx of migraines w/aura

A

only have to have 2 HA with clear aura descritpion

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3
Q

when is prophylatic migrane meds used

A

with 4+ migrains per mo

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4
Q

Mainstay of migrane prevention

A

-lifestyle mods
-BBlockers

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5
Q

Prophylactic migrane meds

A

-bblockers
-trycyclic antidepressants
-topamax
-depakote

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6
Q

Go to abortive migraine tx

A

-asa
-tylenol
-caffine

then triptans

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7
Q

Inflammatory markers of are elevated with temporal arteritis

A

crp and esr

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8
Q

How to treat temporal arteritis

A

long term steroids 1-2 yrs
symptoms typically resolve quick

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9
Q

Prophylatic drug for cluster HA

A

verapamil

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10
Q

cluster HA attack abortives

A

-High flow O2
-imitrex

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11
Q

A thunder clap headache is often associated with

A

stroke

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12
Q

what are some residual SE of TIA

A

-paralysis
-aphasia

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13
Q

Treatment for bells palsy

A

-steroid within 72hrs
-antivirals
-eye ointment

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14
Q

What type of tremor is present with parkinson

A

resting

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15
Q

when do essential tremmors occur

A

-occurs with intent

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16
Q

treatment of essential tremors

A

-bblockers
-regular physical activity

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17
Q

Why is ropinirol useful in parkinson

A

useful for tremors

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18
Q

SE of consussion

A

-HA
-Dizziness
-confusion
-sleepiness/lethargy

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19
Q

treatment for mild concussions

A

-decrease screen time
-rest
-slowly return to activity

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20
Q

potential complications of severe concussions

A

-hypoxia
-internal bleeding
-death

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21
Q

when is MS frequently dx

A

20-40yo

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22
Q

pts with MS are at an increased risk of

A

trigeminal neuralga

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23
Q

how to treat MS

A

-specialist- DMARDs

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24
Q

S/S of MS

A

-muscle weakness
-balance issues
-incontinence
-vision complaints (often presenting symptom)

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25
Q

what causes meninigitis

A

-bacterial
parasite
-virus

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26
Q

S/S of meningitis

A

-flu like at first (fever, fatigue, body aches)

Then get much sicker:
-confusion
-difficulty walking
-skin rashes
-vomiting.anorexia
-c/o severe HA
-stiff neck

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27
Q

Compications of meningitis

A

-seizures
-hearing loss
-memory issues
-learning issues
-shock/death

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28
Q

how to dx meningitis

A

-lumbar puncture (WBC and bacteria in fluid)

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29
Q

absence seizures common in

A

kids (often accused of daydreaming)

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30
Q

how to dx absence seizures

A

eeg but hard to catch

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31
Q

S/S of absence seizures

A

look off and blankly stare for 20-30s or eye flutter

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32
Q

Tx of absence seizure

A

-outgrow

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33
Q

Tonic clonic seizure

A

grandmal

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34
Q

tonic phase

A

stiffening

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35
Q

clonic phase

A

jerking

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36
Q

how long do grandmals last

A

3 mins
(911 if longer than 5)

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37
Q

SNRI examples

A

-duloxetine
-venlafaxine

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38
Q

SSRI examples

A

-fluoxetine
-praoxetine
-sertraline

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39
Q

Fluoxetine

A

-jittery
-long half life

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40
Q

paroxetine

A

-sedating
-jittery

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41
Q

escitalopram

A

-quick
-good for anxiety

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42
Q

sertraline

A

-good for elderly (low SE)

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43
Q

three categories of insomnia

A

transient <1w
Short term 2-3mo
chronic 3mo+

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44
Q

Non-benzo sleep meds

A

-ambien
-lunesta

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45
Q

benzo sleep med

A

xanax

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46
Q

non-modifiable HTN risks

A

-old
-black
-male
-family hx

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47
Q

S/S HA

A

-fatigue
-HA
-Vision changes

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48
Q

Normal BP AHA

A

<120/80

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49
Q

Elevated BP AHA

A

120-129/<80

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50
Q

Stage one BP AHA

A

130-139/80-89

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51
Q

Stage two AHA

A

140+/90+

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52
Q

Goal AHA

A

<130/80

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53
Q

What are three microvascular complications with HTN

A

-retinopathy
-nephropathy
-neuropathy

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54
Q

groups that benefit from statins

A

-high ASCVD risk
-Prior cardiac event
-LDL >190
-DM
-40-75yo

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55
Q

low intensity stating

A

-pravastatin
-simvastatin

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56
Q

What will CK/CR be in rhabdo

A

5-10x normal

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57
Q

what causes atypical PNE or “walking pne”

A

mycoplasma (milder but more persistant)

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58
Q

what causes typical pne

A

streptococcus PNE

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59
Q

avoid what when treating pne

A

cough suppresants (expectorants ok)

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60
Q

When to FU pne

A

8w FU CXR

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61
Q

what is >10 on the CAT assessment

A

significant daily disruption due to COPD

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62
Q

Group A

A

CAT <10
0-1 exacerbations

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63
Q

Group A tx

A

ONE bronchodialator
-SABA- albuterol
or
-LABA- Formoterol

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64
Q

Groub B

A

CAT >10
0-1 exacerbations

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65
Q

groub B tx

A

LABA or LAMA (tiotropium)

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66
Q

group c

A

CAT <10
Many exacerbations

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67
Q

group c tx

A

LAMA (tiotropium)

(could also do LABA+LAMA)

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68
Q

Group D

A

Cat >10
Many exacerbations

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69
Q

group d tx

A

LABA plus LAMA
REFER to PULM

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70
Q

mild COPD exacerbation treatment

A

-saba

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71
Q

moderate COPD exacerbation treatment

A

SABA + abx/steroids (macrolide or tetracycline)

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72
Q

Severe COPD exacerbation treatment

A

admit

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73
Q

Fev1 of >80

A

intermittent or mild persistnt

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74
Q

fev1 60-80

A

moderate

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75
Q

fev1 <60

A

severe (refer)

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76
Q

step 1

A

FEV1 >80%
Symptoms <2x/mo
ICS-LABA PRN

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77
Q

step 2

A

Fev1 >80%
symptoms >2x/mo but not daily
ICS daily

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78
Q

Step 3

A

FEV160-80
symptoms most days NA x1weekly
ICS LABA daily or ICS w/LTRA (singular)

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79
Q

Step 4

A

Fev1<60
Refer
Medium ddose ICS daily

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80
Q

who is SLE most common in

A

women of child bearing age 15-45

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81
Q

symptoms of SLE

A

vague
-fatigue
-joint pain
-mental fog

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82
Q

11 criteria of which 4 must be present for SLE

A

-malar rash
-discoid rash
-photosensitivity
-oral/nasal ulcers
-arthritis
-cardio/pulm complaints
-renal complaints
-neuro complaints
-immuno disorders
-+ ANA
-heme disorders

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83
Q

what do we need to watch for with lupus

A

proteinuria

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84
Q

intital old folk levothyroxine dose

A

12.5-25

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85
Q

initial adult levothyroxine dose

A

25/50

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86
Q

What is myxedma coma

A

Severe hypothyroid emergency

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87
Q

s/s of myxedma coma

A

-low temp
-swelling
-confusion
-lethargy
-difficulty breathing
-coma/death

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88
Q

Which medication can precipitate myxedma coma

A

-lithium
-amiodarone

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89
Q

hyperthyroidism complications

A

-heart disease/hf
-osteoporosis
-infertility

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90
Q

S/S of thyroid storm

A

-hyperthermia
-tachy
-HTN

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91
Q

cause of thyroid storm in hyperthyroidism

A

-infection, trauma, radioactive iodine

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92
Q

starting metformin dose

A

500

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93
Q

dialysis at what gfr

A

<15

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94
Q

BUN is affected by

A

-hydration and liver

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95
Q

normal HBG

A

12-18

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96
Q

normal HCT

A

36-54%

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97
Q

causes of iron deficiency in kids <1yr

A

cows milk

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98
Q

how is hep b transmitted

A

-blood
-semen
-body fluid

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99
Q

s/s of hep b

A

-abdominal pain
-fatigue
-dark urine
-nausea
-jaundice

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100
Q

hep b tx

A

-often resolves on own but can be chronic

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101
Q

PrEP

A

-prevention meds

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102
Q

PEP

A

post-exposure meds

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103
Q

gold standard HIV screening

A

HIV1/HIV2 antigen antibody immunoassay

(alsa and western blot old)

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104
Q

normal CD4 count

A

500-1600

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105
Q

CD4 to start antivirals

A

350 or less

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106
Q

Diagnostic aides CD4

A

200 or less

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107
Q

macrocytic anemias are always

A

normochormic

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108
Q

where is malaria found

A

tropical warm african counteries

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109
Q

how is malaria spread

A

inscect bites

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110
Q

s/s of malaria

A

-fever
-fatigue
-HA
-malaise
-joint aches
-n/v
-INCREASED BILI

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111
Q

treatment for active malaria infection

A

-chloroquine
-malarone

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112
Q

Prevention malaria med

A

-atovaquone/proguanil (malarone)
-Cloroquine

113
Q

How is chloroquine taken

A

weekly

114
Q

How is Malarone taken

A

daily

115
Q

Which malaria drug is ok in pregnancy

A

chloroquine

116
Q

Issue with chloroquine

A

doesnt work on all tipes of malaria

117
Q

issue with malarone

A

harsh on kidneys

118
Q

how to dx malaria

A

blood test (parasitic)

119
Q

HOw long is malaria incubation period

A

6-18 days

120
Q

GERD s/s

A

-sore throat
-regurgitation
-cough
-chest pain

121
Q

risk factors for GERD

A

-smoking
-obesity
-pregnancy
-aging

122
Q

two types of PUD

A

-doudenal
-gastric

123
Q

causes of PUD

A

-NSAID overuse
-H. pylori

aggrivating factors
-stress
-smoking
-alcohol

124
Q

s/s of doudenal ulcer

A

-pain RELIEVED by eating
-pain occurs 1-3hrs after eating

125
Q

s/s of gastric ulcer

A

pain is increased by eating

126
Q

best way to dx h.pylori

A

fecal antigen is best

127
Q

other ways to dx h.pylori

A

-urea breath test (easy and cheap but must stop h2/ppi for 2weeks)
-Serum antibody test (will be positive if you have ever had it)

128
Q

how to treat PUD if no by h. pylori

A

H2 or PPI

129
Q

causes of pancreatitis

A

-alcoholism
-gallstones (block CBD)
-Increased Ca+ levels
-Increased triglycerides

130
Q

s/s of pancreatitis

A

-LUQ pain worse when supine
-significant n/v

131
Q

pancreatitis tx

A

-Treat cause
-Allow pancrease to rest (NPO)
-manage symptoms (pain meds, abx, fluids)

132
Q

most common cause of gastroenteritis

A

viral

133
Q

S/S of gastroenteritis

A

-n/v
-diarrhea
-abd pain
-wt loss
-s/s dehydration

134
Q

Tx of gastroenteritis

A

-FLUIDS
-Antiemetics
-antidiarrheals
-BRAT diet

135
Q

labs for gastroenteritis

A

-CBC
-CMP
-UA
-STool studies if lingering (occult, cultur, cdiff, ova)

136
Q

Causes of bacterial gastroenteritis

A

-salmonella
-shigella
-e. colli
-campylobacter

137
Q

TX of bacterial gastroenteritis

A

-Fluoroquinolone
or
-Macrolide

138
Q

Gardia tx

A

metronidazole

139
Q

stage one kidney

A

kidney damage with normal function
GFR >90

140
Q

Stage 2 kidney

A

mild loss of function
GFR 60-89

141
Q

two asymptomatic kidney stages

A

1 and 2 CKD

142
Q

Stage 3 kidney

A

mod-sever loss of function
GFR 39-59

143
Q

Stage 5 CKD

A

end stage with no urine
GFR <15

144
Q

Stage 4 kidney

A

severe function loss
GFR 15-29

145
Q

tx of endometriosis

A

-ocp (decreases growth of endo tissue)
-Meds
-Surgery (removal of endo tissue)

146
Q

symptoms of endometriosis

A

-debilitating peroids
-irregular cramping
-heavy flow
-anemia
-

147
Q

causes of endometriosis

A

-Mostly unknonw
-Retrograde menstruation
-surgery (c’s, hyster)
-immune disorders

148
Q

complications of endometriosis

A

-infertility
-increased ovarian and enometrial cancer rates

149
Q

Rotterdam criteria for PCOS dx

A

-anovulation
-increased androgen levels
-multiple cysts

150
Q

S/S PCOS

A

-acne
-hirsutism
-acanthosis nigricans
-irregular periods
-wt gain

151
Q

Tx of PCOS

A

-healty lifestyle choice
-OCP
-metformin
-spirnolactone (suppress androgens)

152
Q

complications of PCOS

A

-DM
-hyperlipidemia
-HTN
-Increased endometrial CA risk

153
Q

when and how often mammograms

A

-start at 50-74yo q2yrs
-Not reccomended past 74

154
Q

most common cause of breast lumps

A

fibrocytic breasts

155
Q

Most common cause of fibrocytic breasts

A

menstrual cyclet

156
Q

tx of fibrocytic breasts

A

-OCT pain meds
-US
-Reassess after peroid

157
Q

S/S of fibrocytic breasts lumps

A

-firm
-tender/sore
-movableR

158
Q

risks for breast CA

A

-No kids/no breastfeeding
-sedentary lifestyle
-age
-genetics

159
Q

S/S breast CA

A

-fixed painless lumps
-dimpling
-read flakey nipples
-discharge

160
Q

average age menstrual cycle

A

12yo

161
Q

primary amenorrhea

A

no peroid start by age 15

162
Q

secondary amenorrhea

A

-pregnancy
-underlying causes

163
Q

what is primary dysmenorrhea

A

no underlying cause

164
Q

what is secondary dysmenorrhea

A

-cause such as endometriosis or STIs

165
Q

who has dysmenorrhea at higher rates

A

teens in their first year of peroids

166
Q

tx of dysmenorrhea

A

-NSAIDS
-Hormonal OCP

167
Q

normal size of prostate

A

walnut

168
Q

when does BPH usually start

A

after 50yo

169
Q

What issue do we sometimes see with BPH

A

bacterial overgrowth in bladder (UTI)

170
Q

what other tests are indicated for prostatitis

A

-STI
-urine culture

171
Q

S/S prostatitis

A

-pelvic/abd pain
-dysuria
-nocuturia
-urgency/frequency

172
Q

Treatment for prostatitis

A

-treat STI
-Levoquin
-bactrim

173
Q

average age prostate CA

A

66

174
Q

risk factors for prostate CA

A

-age
-black
-family hx

175
Q

Average age for testicular CA

A

-young-middle age

176
Q

s/s of testicular CA

A

-firm, fixed painless nodule

177
Q

s/s of a vericocele

A

-asymptomatic
-bag of worms

178
Q

what is blanitis

A

swelling and irritation of the glans penis

179
Q

cause of blanitis

A

candida most common

180
Q

risk factors for blanitis

A

-uncircumsized
-poor hygine
-DM

181
Q

s/s blanitis

A

-erythema
-itching
-pain
-discharge

182
Q

tx for blanitis

A

-topical antifungal
-culture

183
Q

what is peyronie’s disease

A

curvature of penis as a result of fiborous scar tissue (trauma)

184
Q

S/S of peyronies disease

A

-painful erection

185
Q

tx for peyronies

A

uro referral (verapamil injection)

186
Q

risk factor for priapism

A

sickle cell anemia

187
Q

what can allopurinol do long term

A

bone marrow suppression -get CBC

188
Q

kyphosis is a late sign of what

A

osteoporosis

189
Q

what does the ACL do

A

-stabalizes knee with rotational movement

190
Q

what does the meniscus do

A

-stabalize knee
-lubricate joint

191
Q

s/s of meniscus tear

A

“pop” and “lock”
-able to finish game
-delay in swelling over 24 hoursq

192
Q

s/s of ACL tear

A

-pain occurs after “pop” in less than 1 hour

193
Q

what labs will be elevated with RA

A

-RF
-ESR

194
Q

tx of RA

A

-rhuma referral
—-DMARDs

195
Q

risk factors for fibromyalgia

A

-women
-middle aged
-lupus
-RA

196
Q

most common cause of infant dealth

A

-birth defects

197
Q

most comon cause of kid death

A

1-4=drowning
teens=MVA

198
Q

Trust v/s mistrust

A

infants-18mo
knowing needs will be met by caregiver

199
Q

autonomy vs shame

A

age 3-4
test boundaries,
making choices,
sense of control

200
Q

initiative vs guilt

A

3-5
learn place in world
asks questions
friendships develope

201
Q

industry vs inferiority

A

12
comparing self to peers
examining skills
likes/dislikes

202
Q

identity vs role confusion

A

teens/college
“who am i?”

203
Q

intimacy vs isolation

A

searching for mate/village
identity development

204
Q

generativity vs stagnation

A

older adults
need to give back to others

205
Q

integrity vs dispare

A

being proud of life

206
Q

when do babs return to birth weight

A

2w

207
Q

roll over

A

2mo

208
Q

tooth eruption

A

6mo

209
Q

unilateral hand skill

A

9mo

210
Q

1-2 mo vax

A

polio
hib
pne
rota
dtap

211
Q

birth vaccine

A

hep b

212
Q

6mo vax

A

flu

213
Q

age for HPV

A

as early as 9 but 11 is ideal

214
Q

which strains hpv

A

16/18
warts-6-11

215
Q

when will hemangiomas resolve

A

by age 4

216
Q

s/s of jaundice in infants

A

-fussiness
-poor feeding

217
Q

tx varicella-

A

avoid scratching
antypyretics
callomine lotion/oat baths

218
Q

what can kawaski lead to

A

aquired heart disease

219
Q

when do molloscum contagiosum resolve

A

by self in 6-12mo

220
Q

what makes atopic derm worse

A

-cold
-stress

221
Q

what is scarlatina

A

the scarlet fever (strep throat) rash
-sandpaper maculopapular rash

222
Q

tx scarlatina

A

amoxicillin!

223
Q

when would you see palatine petiachea

A

-strep

224
Q

when will blocked tear ducts self resolve

A

4-6mo
warm compresses/massage

225
Q

common pathogen for AOM

A

-strep pne

226
Q

tx of otitis externa

A

ofloxacin gtts
cortisporin gtts

227
Q

common cause of OExterna

A

psudomoniasis argulosa

228
Q

when do we start kid BP checks

A
  • birth
    -routinely until 3yoa
229
Q

when is fystic fibrosis commonly diagnosed

A

prior to age 2

230
Q

s/s of CF

A

-frequent infections
-thick productive cough
-wt loss
-foul/greasy stool
-dyspnea
-salty skin

231
Q

dx CF

A

-sweat chloride test
-genetic testing

232
Q

tx of RSV

A

supportive
-antipyretics
-fluids
-monitor RR

233
Q

s/s croup

A

BARKY COUGH
stridor
fever

234
Q

tx for croup

A

-dexamethasone

235
Q

when to send croup to ED

A

-with stridor or severe dyspnea

236
Q

how long are kids contageous with pertussis

A

2w

237
Q

s/s epiglottitis

A

-difficulty breathing/swallowing
-stridor.muffled voice
-leaning forward and DROOLING

238
Q

xray with epiglottitis

A

“thumbprint sign”

239
Q

cause of epiglottitis

A

HIB

240
Q

what is encopresis

A

Fecal incont. after successful potty training

241
Q

causes of encopresis

A

-holding it causing colon to enlarge and desensitize

242
Q

mgt of encopresis

A

-retrain colon
-fluids, diet, exercise, stool softners

243
Q

when should cryptorchidism self resolve

A

6mo

244
Q

cryptorchidism most common in

A

premies

245
Q

s/s vesicouretral reflux

A

frequent UTI or pylo

246
Q

what is a nephroblastoma

A

“wilms tumor”
form of renal CA

247
Q

s/s of nephroblastoma

A

-small abdominal mass that does NOT cross the midline

248
Q

what to do if s/s wilms tumor

A

-DO NOT PALPATE HARD
-REFER
-us

249
Q

s/s of salter-harris fx

A

pain
limited ROM
inflammation
swelling

250
Q

what is nursemaids elbow

A

-radial head sublux

251
Q

tx of nursemaids elbow

A

-closed reduction in office

252
Q

risk factors for developmental dysplasia of hip

A

-breech
-female
-family hx
-oligohydramonisis
-1st born

253
Q

when will there be s/s developmental dysplasia of hip

A

-birth
-up to 1yo

254
Q

tx of developmental dysplasia of hip

A

-pavlik harness early
-closed reduction and spika cast

255
Q

s/s developmental dysplasia of hip

A

-asymmetric gleuteal folds
-unequal leg lengths
-abnormal gait/mvt

256
Q

tests for developmental dysplasia of hip

A

-ortolani and barlows

257
Q

What is legg-galve-perthes disease

A

osteonecrossis of femoral head

258
Q

when is typical time to find legg-galve-perthes disease

A

4-8yo

259
Q

dx of legg-galve-perthes disease

A

-xray or MRI

260
Q

s/s legg-galve-perthes disease

A

-hip pain
-limp
-positive trendelenbeurg test (cannot stand on one leg without tilting pelvis)

261
Q

tx for legg-galve-perthes disease

A

ortho referral

262
Q

what is slipped capital femoral epiphysis

A

when femoral head slips out and damages growth plate

263
Q

s/s of slipped capital femoral epiphysis

A

-hip pain
-unequal leg lengths
-limp unable to bear wt
-+ trendelenburg sign

264
Q

slipped capital femoral epiphysis dx

A

xray

265
Q

when does slipped capital femoral epiphysis usually occur

A

-adolescents
-growth spurts
-trauma
-oesity

266
Q

tx for slipped capital femoral epiphysis

A

ortho referral

267
Q

when to refer kids with scoliosis

A

20 degrees plus

268
Q

s/s downs

A

-flat face
-small lowset ears
-almont eyes
-palmar crease

269
Q

what is turners

A

when females only have one x

270
Q

what is klinefelter syndrome

A

when males are born with 2x’s which causes testosterone issues

271
Q

s/s of klinefelters

A

-large head circ
-delayed milestones
-mental disabilities

272
Q

what is spina bifida

A

neural tube doesnt close right

273
Q

s/s of spina bifida

A

-sacral dimple or patch of hair

274
Q

tx for febrile seizures

A

-dont treat no long term damage

275
Q

when to go to ED with febrile seizures

A

-over 5min

276
Q

Autism screening tool

A

M-CHAT

277
Q

tx for ADHD

A

-<6yo CBT
-if over- meds and CBT

278
Q
A

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